Utility of Cyst Fluid Carcinoembryonic Antigen in Differentiating Mucinous and Non-mucinous Pancreatic Cysts: An Updated Meta-Analysis

Khan, Imadh; Baig, Muhammad A.; Bandepalle, Thrisha; Puli, Srinivas R.

doi:10.1007/s10620-021-07315-5

Cited by 7 publications

(5 citation statements)

References 32 publications

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“…Discrimination between PCLs remains difficult because the diagnostic sensitivity for mucinous PCLs using EUS remains 71% and 68–88%, respectively, for the two types of lesions when intracystic CEA level is considered [ 23 ]. For this reason, intracystic glucose level seems to be promising, as noted in three meta-analyses published in recent years, with 90–92% sensitivity and a specificity of 65–86% [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions

Olar,

Iacobescu,

Bolboacă

et al. 2024

IJMS

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Undetermined pancreatic cystic lesion (PCL) differentiation benefits from endoscopic ultrasound (EUS) based on morphology and cyst fluid analysis, but room for new biomarkers exists. Our aim was to assess the intracystic and serum diagnostic value of neutrophil gelatinase-associated lipocalin (Ngal) and interleukin 1 beta (IL-1β) for differentiation of PCLs. This prospective study included patients from one tertiary hospital, evaluated between April 2018 and May 2020. EUS fine-needle aspiration or pancreatic pseudocysts drainage was the source of PCL intracystic liquid. The final diagnosis was based on surgery or EUS results (morphology, cytology, glucose, and CEA—carcinoembryogenic antigen). The intracystic samples were tested for Ngal, IL-1β, glucose, and CEA, and serum for Ngal and IL-1β. We evaluated 63 cysts, 33 pseudocysts, and 30 non-inflammatory cysts. The diagnostic sensitivity and specificity for mucinous PCL was 70.8% and 92.3% for intracystic Ngal (cut-off: 500–800 ng/dL), without correlation with serum Ngal, no matter the inclusion of infected pseudocysts. After exclusion of infected pseudocysts, the sensitivity and specificity for glucose were 87% and 75%, respectively, and for CEA, they were 87.1%, and 96.8%, respectively. Intracystic Ngal shows promise in differentiating mucinous PCLs, but researchers need to conduct further studies to confirm its effectiveness. Intracystic IL-1β and serum Ngal made no diagnostic contribution.

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Section: Discussionmentioning

confidence: 99%

Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions

Olar,

Iacobescu,

Bolboacă

et al. 2024

IJMS

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“…Conventional cyst fluid analysis with carcinoembryonic antigen (CEA) level, amylase/glucose concentration, and cytological examination, is useful in the diagnostic work-up of PCLs [ 58 , 59 , 60 , 61 ]. However, these tests are limited in their diagnostic accuracy, particularly in terms of sensitivity for identifying malignancy and differentiating PCL subtypes [ 62 ].…”

Section: Determining Pcl Type To Guide Managementmentioning

confidence: 99%

“…However, these tests are limited in their diagnostic accuracy, particularly in terms of sensitivity for identifying malignancy and differentiating PCL subtypes [ 62 ]. CEA is useful for differentiating between mucinous and non-mucinous lesions, although its accuracy is only ~70% [ 58 , 59 ]. Cyst fluid glucose has shown better sensitivity (90%) and specificity (82%) than CEA in distinguishing mucinous from non-mucinous PCLs [ 60 , 61 ].…”

Section: Determining Pcl Type To Guide Managementmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Ablation of Premalignant Pancreatic Cysts and Pancreatic Cancer

Vargas,

Dutta,

Carpenter

et al. 2024

Diagnostics

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Pancreatic cancer is on the rise and expected to become the second leading cause of cancer-related death by 2030. Up to a one-fifth of pancreatic cancers may arise from mucinous pancreatic cysts, which are frequently present in the general population. Currently, surgical resection is the only curative approach for pancreatic cancer and its cystic precursors. However, only a dismal proportion of patients are eligible for surgery. Therefore, novel treatment approaches to treat pancreatic cancer and precancerous pancreatic cysts are needed. Endoscopic ultrasound (EUS)-guided ablation is an emerging minimally invasive method to treat pancreatic cancer and premalignant pancreatic cysts. Different ablative modalities have been used including alcohol, chemotherapy agents, and radiofrequency ablation. Cumulative data over the past two decades have shown that endoscopic ablation of mucinous pancreatic cysts can lead to cyst resolution in a significant proportion of the treated cysts. Furthermore, novel data are emerging about the ability to endoscopically ablate early and locally advanced pancreatic cancer. In this review, we aim to summarize the available data on the efficacy and safety of the different EUS-ablation modalities for the management of premalignant pancreatic cysts and pancreatic cancer.

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“…It is worth emphasizing that the levels of CEA may be used to differentiate between mucinous and non-mucinous lesions [ 55 ]. CEA level of >192 μg/L is the cut-off value for the cyst differentiation with the sensitivity and specificity of 52–78% and 63–91%, respectively [ 56 , 57 ]. In turn, the concentration of amylase is usually normal, however a high level does not exclude MCN [ 31 ].…”

Section: Types Of Incidental Pancreatic Lesionsmentioning

confidence: 99%

Pancreatic Incidentaloma

Caban

Małecka-Wojciesko

2022

JCM

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Pancreatic incidentalomas (PIs) represent a clinical entity increasingly recognized due to advances in and easier access to imaging techniques. By definition, PIs should be detected during abdominal imaging performed for indications other than a pancreatic disease. They range from small cysts to invasive cancer. The incidental diagnosis of pancreatic cancer can contribute to early diagnosis and treatment. On the other hand, inadequate management of PIs may result in overtreatment and unneeded morbidity. Therefore, there is a strong need to evaluate the nature and clinical features of individual PIs. In this review, we summarize the major characteristics related to PIs and present suggestions for their management.

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Utility of Cyst Fluid Carcinoembryonic Antigen in Differentiating Mucinous and Non-mucinous Pancreatic Cysts: An Updated Meta-Analysis

Cited by 7 publications

References 32 publications

Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions

Neutrophil Gelatinase-Associated Lipocalin for the Differentiation of Mucinous Pancreatic Cystic Lesions

Endoscopic Ultrasound-Guided Ablation of Premalignant Pancreatic Cysts and Pancreatic Cancer

Pancreatic Incidentaloma

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